Evaluation of Chemical, Biological, Radiological, Nuclear Explosive (CBRNE) knowledge change and skills confidence among front-line providers during the Russia-Ukraine War

Objective:

To evaluate the change in knowledge and skill confidence after implementation of a CBRNE training course during the Russia-Ukraine War.

Methods:

Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen CBRNE courses were conducted over a 3-month period, August – October 2022. Change in knowledge and skills confidence were evaluated with pre/post-course written exams and practical skill assessments that were observed during the training exercises. Changes were analyzed based on nonparametric Wilcoxon matched-pairs signed-rank testing. Pre/post self-efficacy surveys were analyzed with McNemar’s test for paired data. Course evaluations were conducted with standardized questions which assessed instruction quality, teaching relevance, knowledge gained, and post-course skills confidence.

Results:

523 participants registered and completed one of the fifteen courses. Overall mean pre-course test score: 57.8% (SD 20.7%); mean post-course test score: 81.4% (SD 11.3%); participants with increasing test scores: 90.7%; mean difference in score (95% CI) 23.6% (21.2%–25.9%), p<0.0001. Pre/post self-efficacy surveys (4-point Likert scale) noted participants recognized signs and symptoms of a CBRNE incident, and necessary skills to manage CBRNE exposures, p<0.0001.

Conclusions:

The implementation of this CBRNE course for front-line providers in Ukraine was successful. To our knowledge, it was the first implementation of a field course during the current Russian-Ukraine war. Future research should evaluate knowledge retention and impact of our innovative “train-the trainer” model. Further iterations should emphasize expanding the quantity of training equipment and practical skill sessions.